The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left (part 4)

Kotelchuk, Rhonda, and Levy, Howard (1986). The Medical Committee for Human Rights: A Case Study in the Self-Liquidation of the New Left. In Race, Politics, and Culture: Critical Essays on the Radicalism of the 1960s. Reed, Adolph, ed. New York, Greenwood Press.

Factions: The Dissidents

Some within the organization perceived the limitations of the national office's top-down bureaucratism. These members, largely from the older big city chapters, including New York City, Boston, San Francisco and Los Angeles, were unimpressed with the large numbers of new recruits flocking to the MCHR. They saw the numbers as reflections not of the success of present leadership and policy but rather of the ferment created by the civil rights and antiwar movements, as well as the past reputation and visibility that the MCHR had established for itself. What did impress them, however, was the fact that both nationally and locally MCHR had become a gigantic revolving door. Interested people came to it, looked around for meaningful involvement, more often than not could not find it and then left in droves almost as large as those in which they had come. For this syndrome the MCHR's array of task forces offered no remedy. This faction shared an acute sense of the MCHR's being in trouble---not for lack of projects, but for lack of a unifying program, a direction that would inform not only national organizing but local struggles as well.

Correct as their criticisms may have been, this group found itself in an untenable position. Its members were united by little more than opposition to the style and politics of the national office and in answer to it, by a vague sense of the need to limit constituency and to focus on institutional organizing which itself went hardly beyond the level of slogans. What the group needed but lacked was both a theoretical and a practical sense of what it might do to actually act upon these vague parameters. Necessarily this shortcoming allowed the national office to charge, with partial plausibility, that the effect of the dissidents was merely destructive and obstructionist.

The true weakness of the dissidents can be seen in their inability to implement their own strategic orientation in a situation where they exercised complete control---at the level of their local chapters. Even in New York City and San Francisco, cities that had already experienced collectives doing institutional organizing, the MCHR dissidents were both peripheral to these efforts and were unable to emulate or go beyond them.

The weakness of the dissidents' position stemmed from their inability to develop three elements critical to the launching of a successful strategy: a concrete, human and unrhetorical explanation of how and why the existing health-care system devalues human experience; an analysis of the contradictions inherent in the system that could inform organizing perspectives by providing the bridge between theory and concrete reality; and finally, the incorporation within an organizing strategy of a means of realizing intermediate stages of an ultimate vision of a health-care system in which the needs of patients were the central focus and in which control was vested in an egalitarian workforce. Nothing less than the forging of these three links could create the conditions that would make possible the desired result---enabling individuals to experientially understand that it is both their responsibility and potentially within their power to become the agents of the construction of their own future.

In some ways the existence of groups such as those at Lincoln Hospital and San Francisco General Hospital may even have obscured the possibilities of institutionally based organizing with middle-level and upper-level health workers. The embarrassing truth was that at a very early stage of the organizing at such institutions, it was clear that the organizers had themselves very little sense of strategy and direction.¹ Worse yet, the romanticization of these early institutional struggles, while intending to move health workers elsewhere to join the struggle, ultimately had the opposite effect---the blocking of a process of thought that might lend clarity, direction, vision, and strength to strategic options and implications of institutional organizing.

In this regard we would be remiss in not placing some of the onus for this state of affairs on Health/PAC, whose bulletin more than any other intellectual journal fostered the idealization of these struggles. This posture sprung from the felt need, conveyed in dozens of ways by movement groups during these uncritical years, of presenting a positive image of the possibilities of social change so as to encourage the growth of the movement. The end result of such unreflective and unwarranted positivity was epidemic disillusionment, divorce from reality, and fostering of false premises, all of which were without doubt self-defeating. Finally, this intellectual euphoria depleted groups such as Health/PAC of their ability to delve deeper into an analysis of the health system and its oppressiveness to workers and consumers, which analysis alone can ultimately form the foundation of a movement for social change.²

Factions: The National Office

The national office faction consisted of Quentin Young, Frank Goldsmith and Pat Murchie---the editors of Health Rights News---and the leaders of both the Third World caucus and the Occupational Health Task Force. Although later events would reveal the fragility of this coalition, to the dissidents this group at the time seemed monolithic, if not conspiratorial as well.

Fueling the dissidents' readiness to see a conspiracy were the facts that several people in the national office faction were open or reputed members of the Communist Party and that the national office faction could depend on support from groups and/or individuals in New York and the South that had long been associated with the Party. Whether or not particular individuals were actual Party members and whether or not the Party made a conscious policy of putting forth its line in the organization, there is no question that many aspects of the national office leadership were reminiscent of the Old Left, including its united-front approach to constituency, its mass-line, least-common-denominator approach to the program, its bureaucratic style, its opportunistic use of issues, and its centralist orientation, with its intolerance of differences or criticisms from within the organization.

The national office felt that the success of its political leadership was confirmed by the large numbers of new people turning out to MCHR functions. Because it was better organized and shared more political unity than anyone else, it felt no need to discuss political directions or develop a program for the organization. Instead, it felt threatened when others wished to do so, because this felt need in itself represented criticism, and because such discussion could not but weaken its position. Indeed, before long the energy expended by the national office at thwarting criticism and fending off dissent almost came to define its entire operation.

Keeping Dissent at Bay

It was in the end the unwillingness of either faction to back off and the repressive tactics stemming from the centralist stance of the national office that led the MCHR down the road to factionalism and demise. The national office honed a set of tools with which it attempted to discredit, silence and eventually expel dissenters. Questions probing the content or meaning of the numbers, the claims or the style of the national office were taken as hostile attacks. From a disturbingly early stage in the new regime, people were seen as either friends or enemies and there was little in between. New activists were warmly embraced and solicited by officers and staff until the first time they expressed doubts or criticism, whereupon they became pariahs. Old friends who dissented were at first ignored or dismissed out of hand and later branded as negative, destructive, localist and ultra-Leftist.

Structuring Out Dissent

The most subtle of these tools for repressing dissent was the structuring of MCHR gatherings so that it was difficult if not impossible for dissidents to meet or talk. This tactic involved rigidly tight scheduling and the use of constant fragmentation into small groups, all for the purpose of precluding any occasion for a broad discussion of overall politics. At the 1972 convention in Chicago, for example, the leadership scheduled some forty workshops and fifteen constituency caucuses. As a result, the four-day convention provided only a short Sunday morning plenary session as a forum for organizational business. Older members were both frustrated by this maneuver and resentful of the fact that every MCHR gathering was geared to the recruit- ment and needs of new people, who were invariably neither interested in nor experienced with MCHR internal affairs, rather than to the needs of those for whom those internal affairs were of paramount concern.

When older members began to organize occasions compatible with their needs, they were slashingly criticized by the national office. One such occasion came when leaders of the Northeast Region, out of dissatisfaction with the organization of the Chicago convention, organized a largely unstructured re- treat to soberly analyze the organization's directions and viability. The national organizer, when informed of the meeting, threw a virtual tantrum, branding the members involved as elitist, exclusionary and racist, and castigating them for having "No Workshops!...No Caucuses!...No Women's Caucuses!...Task Force and Constituency Organizing Completely By-Passed!"

Dirty Names

The national office wrapped itself in the cloak of a united-front constituency and bureaucratic structural solutions to the MCHR's problems of racism, sexism and elitism in an attempt to immunize itself from criticism. It then used these concerns as epithets to be hurled at its critics. Those who wanted a focused constituency were dubbed exclusionary and elitist, anticonsumer, and antiworker. Those who felt frustrated by the constant fragmentation into special-interest caucuses were dubbed sexist and racist.

By 1972 the MCHR national leadership under Frank Goldsmith's direction had decided upon its tactic---dissidents were to be smeared with the volatile charge of racism. In a written report the MCHR leadership pointed out that the big city chapters had few black members. Unmentioned was the fact that this was true of everywhere.

In New York City an MCHR trip to China provided the nidus for the manipulative use of the racism issue. Partisans of the national office---none of whom theretofore active in the New York City MCHR chapter---suddenly constituted themselves as a separate chapter at Columbia-Presbyterian Medical Center. The group's sole activity was to nominate a black physician, Calvin Sinnett---himself never involved in MCHR---as New York City's delegate to the China sojourn. Protests from the New York City chapter were to no avail and were denounced by the MCHR's Third World Caucus as "racist."

Dirty Tricks

Of course, as with any organization wracked with factionalism, specific tactics are only paint to cover the deeper cracks. At the 1972 MCHR national convention the underlying centralist thrust of the leadership and the latter's need to expel dissidents became clear. Proposed constitutional revisions would have had the effect of lengthening the chairperson's term of office, hiring of staff without the approval of the Executive Committee, and finally would have permitted the NEC to remove from its own ranks members whom the chapter membership had duly elected in the first place.

Although these antidemocratic proposals were soundly defeated, the national office was not to be easily deflected from its goal of eliminating its critics. It now alleged the right of the NEC to simply expel chapters after "investigation," the grounds of which were not explicit (In special cases it was proposed that chapters could be "temporar[ily] disaffiliat[ed]" prior to investigation).

By now polarization within the MCHR had become so great that productive organization and political work, including fund-raising to support critial staff functions, had come to a standstill. Having been ultimately rebuffed at every turn by the MCHR's members, Frank Goldsmith and his staff finally threw in the towel and quit in the fall of 1972. With the demise of the national office and chapter activity at a low ebb, the MCHR fell prey to all the forces then undermining what little remained of organized left activity.

The Aftermath

With the antiwar years over, the larger movement was in disarray. The SDS and the Black Panthers had split, been repressed and faded from the national scene; many local community struggles had faded as well. With the fall of the larger movement rose the star of the Left sectarian groups, whose attraction to activists was their simple, complete, and prepackaged sets of answers to the thorny issues facing the American Left and---probably more importantly---their apparent sense of purpose and community, a welcome contrast to the confusion, fragmentation, and isolation that now characterized the independent Left. Political parlance came to be studded with talk of the Progressive Labor Party, the Communist Party, the October League, the Revolutionary Union and the National Caucus of Labor Committees, to mention only the most prominent.

The MCHR had never anticipated the demise of the many groups that had lent it its raison d'etre. More than that, its residual reputation and appeal to new recruits, its breadth of politics and its lack of self-definition made it a perfect breeding ground for sectarian groups. Once entrenched, such groups added still another obstacle to the MCHR's addressing the critical issues, since it is then put in the reactive position of having constantly to respond to the initiatives of better organized outside forces. The New York and Boston chapters withstood the onslaughts of the Progressive Labor Party only to have the Revolutionary Union rise to take its place there and in other Eastern cities. At the national level, the Communist Party began to function more overtly, and in the following years MCHR members closely associated with the Party were elected as officers and served as staff.

From 1972 on, the MCHR was reduced to the old-hat plight of sectarian Marxist/Leninist intrigue. The communist party vied with the Revolutionary Union (later rechristened Revolutionary Communist Party---RCP) for organization control. While a few "independents" remained and were occasionally allowed access to the national office, they did little more than act as credible fronts to disguise the MCHR's overt turn to "democratic centralism."

The old, mostly Communist Party-based, MCHR leadership was accused by RCP upstarts as having presided over a sputtering organization. Greater militance was the RCP's rallying call, and indeed in several major cities the RCP initiated meetings and demonstrations mostly on the issue of budget cutbacks of public health services. By 1974, the RCP's organizing energy, coupled with the collapse of the nonsectarian left, had won the day and control of the MCHR. The old MCHR leadership stepped aside with Quentin Young left hurling verbal brickbats at his successors from the sidelines.

By 1978 the RCP was split asunder with its own internal sectarian dispute. The issue at stake was whether to support or denounce China's Gang of Four (dubbed "Gang of Five" by the RCP who claimed the ghost of Mao as the holy-spirited fifth member). That an issue so remote from American political experience should become a fulcrum for an ideological split might leave most Americans bewildered. For the Communist Party-oriented former members of the MCHR it might ironically have recalled an earlier decade's bitter wrangling over the issue of Stalinism.

Nationally, the Gang of Four hardliners won out and retained control of the RCP. Within the MCHR, however, the RCP was expelled to be succeeded by a new offshoot calling istelf Revolutionary Workers Headquarters.

All this bitter infighting resulted in an emaciated and enervated MCHR. The 1979 national convention attracted a scant fifty or so participants. Still the organizational bureaucracy ground on, passing resolutions and proposing initiatives. For the most part organizing promised to proceed along traditional liberal left/trade unionist political lines on issues such as occupational health and fighting public hospital budget cutbacks. In addition, efforts were begun to organize nurses upon the issue of proposed legislation that would require by the mid-1980s nurses to hold four-year baccalaureate degrees. The effect of this is alleged to be severalfold: the numbers of working class and minority nursing students are minimized. Further, those who graduate such programs are destined to assume supervisory functions with less well-paid personnel assigned to more demanding on-line nursing and technical duties. As far as they go these may be legitimate concerns; however, they skirt the larger unresolved issue of the role of nursing in today's increasingly technologically oriented medical practice. Similarly, fundamental questions concerning other organizational tactics, including occupational health and budget cutback issues, are left unaddresed.

Observers within the MCHR point to the broadbased appeal of the forementioned organizing initiatives as evidence of a shift away from narrow sectarianism. However, this is mearly the woof and warp of all Marxist/Leninist politics: sectarianism is employed to wrest organizational control to be followed by broad-based united-front politics to later recoup membership which is invariably lost on the way to power. There is nothing on the MCHR horizon to suggest that this seesaw will not be repeated ad nauseum.